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Non-invasive assessment of vessel-wall changes in hypertensives and normotensive controls
C Lemne1, T Jogestrand, U de Faire
1Division of Cardiovascular Medicine, Karolinska Hospital, Stockholm, Sweden.
Insights
Non-invasive ultrasound of carotid artery intimal+medial (I-M) thickness did not differ between early hypertension patients and controls. Left ventricular walls were thicker in hypertensive individuals, suggesting I-M thickness is not an early marker for hypertension.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Hypertension Research
Background:
- Early, untreated hypertension can lead to structural changes in blood vessels.
- Non-invasive methods for assessing these early vascular changes are crucial for timely intervention.
- Intimal+medial (I-M) thickness is a potential marker for subclinical atherosclerosis.
Purpose of the Study:
- To assess the feasibility of using non-invasive ultrasound to detect early vessel wall changes in untreated hypertension.
- To compare carotid artery I-M thickness and left ventricular wall (LVW) thickness between hypertensive patients and normotensive controls.
- To explore correlations between I-M thickness and hypertension-related factors.
Main Methods:
- B-mode ultrasound imaging to measure I-M thickness in the common carotid artery (CCA).
- Echocardiography to assess LVW thickness.
- Comparison between 12 newly diagnosed, untreated hypertensive patients and 9 age-matched controls.
- Correlation analysis with blood pressure, lipids, and LVW thickness.
Main Results:
- No significant difference in CCA I-M thickness between hypertensive and control groups (0.63 mm vs 0.63 mm).
- Hypertensive group exhibited significantly thicker LVW compared to normotensive controls.
- CCA I-M thickness correlated significantly with age (r=0.63, P<0.05) but not with blood pressure, lipids, or LVW thickness.
Conclusions:
- Carotid artery I-M thickness may be less responsive to early pressure overload than left ventricular walls.
- I-M thickness is not a sensitive early marker for structural vessel wall changes in this cohort.
- Future large-scale prospective studies with age-homogenous populations are needed to confirm the utility of I-M thickness in hypertension.
Abstract:
The aim of this study was to evaluate the feasibility of non-invasive assessment of vessel wall changes in early, untreated hypertension. Measurement of intimal+medial (I-M) thickness in the common carotid artery (CCA) using B-mode ultrasound imaging showed no differences between 12 patients with untreated, newly diagnosed hypertension and 9 age-matched controls (0.63 mm vs 0.63 mm just proximal to the carotid bulb). Echocardiography showed that the hypertensive group had thicker left ventricular walls (LVW) than the normotensive group. Correlation analyses disclosed that I-M thickness was significantly associated with age (r = 0.63; P less than 0.05) for the whole material but not with blood pressure levels, serum lipids, or LVW thickness. These results imply that the arterial I-M layers of the CCA are less responsive to pressure overload than the left ventricle. The feasibility of using I-M thickness as an early marker of structural vessel wall changes in hypertensive patients must await results from large scale prospective studies. In view of the present results, age homogenous materials should be selected for such studies.